Individual
JASON FUNDERBURK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6404 S MCCLINTOCK DR, TEMPE, AZ 85283-3942
(480) 838-9200
Mailing address
4630 S LAKESHORE DR, APT. 190, TEMPE, AZ 85282-7164
(215) 292-2373
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S017925
AZ
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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